• Journal of Gastric Cancer
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• 제22권2호
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• pp.145-155
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• 2022

Purpose: Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods: In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results: A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions: Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.

• Journal of Gastric Cancer
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• 제20권2호
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• pp.176-189
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• 2020

Purpose: This study evaluated differences and shifting patterns in the health-related quality of life (HRQoL) of 5-year gastric cancer survivors after either a distal subtotal gastrectomy (DSG) or total gastrectomy (TG). Materials and Methods: We analyzed the prospectively collected HRQoL data of 528 patients who survived 5 years without recurrence using the European Organization for the Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Quality of Life Questionnaire-Stomach module according to the type of surgery. The purpose was to identify the proportion of patients with deteriorating HRQoL and to assess the clinical significance of these changes. Results: Deteriorating HRQoL was prevalent in both groups, including a large proportion of the DSG group. Decreased overall health status and scores on several function scales were less in the DSG group, while increases on the symptom scales were higher in the TG group. For most of the scales, gaps in HRQoL during the early postoperative period did not merge within the 5 years. Scores on the diarrhea and body image scales revealed "moderate changes" in both groups. Conclusions: During the 5-year period after surgery, the TG group suffered from inferior HRQoL compared to the DSG group. However, a large proportion of the DSG group also suffered HRQoL deterioration. In general, the TG group experienced more HRQoL decline, with diarrhea and body image being the major concerns for both groups. To improve HRQoL after gastrectomy, patients must be better informed about post-gastrectomy symptoms. These symptoms must be vigorously investigated, and medical interventions should be available parallel to nutritional support. Favorable evidence of function-preserving gastrectomy should be established and disseminated to improve the HRQoL of early gastric cancer patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.83-92
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• 2008

Helicobacter pylori is the causative agent of chronic gastritis and has a role in the pathogenesis of peptic ulcer diseases, and gastric cancer. There have been reports suggesting a close link between these gastroduodenal disorders and a state of vitamin C deficiency. In this paper, the past, present and future perspectives on H. pylori infection and vitamin C will be discussed under the following view points. Since the ecological niche of H. pylori is the mucus layer and intercellular junctions of the gastric epithelium, the various kinds of host inflammatory cells motivated by the local and systemic immune responses cannot eliminate the microorganisms. When the invading foreign body is not removed, despite full activation of defense mechanisms, adverse consequences of the immune responses develop on the host gastric mucosa. The reasons for the body vitamin C depletion could be explained as follows; 1) the increased vitamin C consumption by increased oxygen free radical production through the prolonged hypersensitivity reactions in the gastric mucosa, 2) the increased vitamin C oxidation by the nitrite which is formed from nitrate reduction by the intragastric bacteria proliferated in the hypochlorhydric gastric cavity, 3) the strong ${\gamma}$-glutamyltranspeptidase activity of H. pylori which depletes the glutathiones in gastric mucosa. Depletion of glutathiones in the stomach favors irreversible oxidative destruction of ascorbic acid. Both persistent inflammatory burdens in the stomach by H. pylori and resultant vitamin C depletions synergistically and uninhibitedly might aggravate the hypothetical sequence of gastric carcinogenesis: atrophic gastritis${\rightarrow}$intestinal metaplasia${\rightarrow}$dysplasia${\rightarrow}$gastric adenocarcinoma. High intake of vitamin C could reverse the hypothetical sequence of the gastric carcinogenesis via direct and indirect effects on H. pylori and host-parasite relationships.

• Journal of Gastric Cancer
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• 제17권2호
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• pp.110-119
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• 2017

Purpose: Patient quality of life (QoL) may be severely disrupted following distal gastrectomy for gastric cancer. This issue should be addressed to improve postoperative care. Materials and Methods: QoL data from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and its gastric cancer-specific module, were administered to 202 patients preoperatively, and 5 years postoperatively. Patients were classified into subgroups based on their answers to each questionnaire item: group I (good), answering "not at all"; group II (fair), answering "a little"; group III (poor), answering "quite a bit" or "very much." Results: At 5 years post-operation, the proportion of patients in group III on the functional scales ranged from 4.3% to 5.7%. The proportions of patients in group III with fatigue, insomnia, diarrhea, and financial difficulties were 8.9%, 9.0%, 11.5%, and 9.1%, respectively. The proportions of patients in group III with anxiety, dry mouth, body image concerns, and hair loss were 12.8%, 10.5%, 9.9%, and 12.6%, respectively. These proportions were less than 5% for other QoL symptom scales/items and for the gastric cancer-specific module. Conclusions: Most patients reported good or fair QoL following surgery. However, symptom management of fatigue, insomnia, diarrhea, anxiety, dry mouth, body image, and hair loss should be specifically targeted for long-term patient care in approximately 10% of patients.

• Journal of Veterinary Science
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• 제21권6호
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• pp.84.1-84.11
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• 2020

Background: Gastroesophageal reflux (GER) has been reported to be a common finding in dogs under general anesthesia. Objectives: The aim of this retrospective study was to assess the esophageal and gastric contents in a population of dogs undergoing computed tomographic myelography (myeloCT) examination and to evaluate the factors influencing the presence of esophageal fluid (gastric content, duration of anesthesia, body position, and intrinsic factors). Methods: Esophageal and gastric contents of 83 non-brachycephalic dogs were retrospectively assessed based on plain and myelo-CT scans. Age, weight, breed, sex, and the time between the 2 computed tomography [CT] scans were included. Results: Esophageal fluid was present in 19% (16/83) of the animals, and 14% (12/83) and 46% (37/83), respectively, had fluid or food material in their stomachs. The frequency of observing esophageal fluid on myelo-CT scans was significantly increased compared with plain CT scans (p = 0.006). The presence of gastric fluid was significantly associated with an increased frequency of observing esophageal fluid compared to other gastric contents (p = 0.049; odds ratio, 3.1). The presence of esophageal fluid was not correlated with alimentary gastric contents (p = 0.17). Increased body weight and duration of anesthesia were significantly associated with an increased frequency of observing esophageal fluid (p = 0.022, p = 0.021). Conclusions: Unlike alimentary gastric contents, fluid gastric contents were correlated with the presence of esophageal fluid upon myelo-CT. The observation of fluid in the esophagus may be consistent with GER. This study provides data additional to pH monitoring studies of GER and may support previous studies recommending shorter pre-anesthetic fasting periods in dogs.

• Journal of Gastric Cancer
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• 제18권3호
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• pp.274-286
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• 2018

Purpose: The aim of this study was to investigate the impact of preoperative low body mass index (BMI) on both the short- and long-term outcomes in patients with gastric cancer. Materials and Methods: A total of 510 patients with gastric cancer were divided into the following 3 groups: low BMI group (${\leq}18.5kg/m^2$, n=51), normal BMI group ($18.6-24.9kg/m^2$, n=308), and high BMI group (${\geq}25.0kg/m^2$, n=151). Results: There were significantly more stage III/IV patients in the low BMI group than in the other groups (P=0.001). Severe postoperative complications were more frequent (P=0.010) and the survival was worse (P<0.001) in the low BMI group. The subgroup analysis indicated that survival was worse in the low BMI group of the stage I/II subgroup (P=0.008). The severe postoperative complication rate was higher in the low BMI group of the stage III/IV subgroup (P=0.001), although the recurrence rate and survival did not differ in the stage III/IV subgroup among all the BMI groups. Low BMI was an independent poor prognostic factor in the stage I/II subgroup (disease-free survival: hazard ratio [HR], 13.521; 95% confidence interval [CI], 1.186-154.197; P=0.036 and overall survival: HR, 5.130; 95% CI, 1.644-16.010; P=0.005), whereas low BMI was an independent risk factor for severe postoperative complications in the stage III/IV subgroup (HR, 17.158; 95% CI, 1.383-212.940; P=0.027). Conclusions: Preoperative low BMI in patients with gastric cancer adversely affects survival among those with stage I/II disease and increases the severe postoperative complication rate among those with stage III/IV disease.

• Journal of Gastric Cancer
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• 제16권4호
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• pp.254-259
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• 2016

Purpose: Owing to increased life expectancy, the number of elderly patients with gastric cancer has increased. This study aimed to identify the outcomes of gastric cancer patients aged 80 years or older through comparison of their clinicopathological characteristics, surgical outcomes, and oncologic outcomes. Materials and Methods: Between January 2006 and December 2013, the records of 478 patients who underwent surgery for gastric cancer were retrospectively evaluated. Patients were divided into two groups: patients <80 years old (n=446) and patients ${\geq}80$ years old (n=32). Results: There were no significant differences in sex, body mass index, length of hospital stay, duration of surgery, depth of invasion, nodal metastasis, histologic type, or tumor size between the two groups. However, significant differences were found for the American Society of Anesthesiologist score and the serum albumin level between the two groups. Postoperative morbidity, mortality, disease-free survival, and recurrence rate did not differ between curatively resected patients in the two groups. Conclusions: In elderly patients with gastric cancer, active treatment including radical gastrectomy is necessary.

• 대한지역사회영양학회지
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• 제11권6호
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• pp.785-792
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• 2006

The purpose of this study was to investigate the nutritional status before and after gastrectomy of gastric cancer patients in Jeonbuk Province. The subjects were 136 patients with gastrectomy of gastric cancer. We assessed the nutritional status before and after an operation by general characteristics (age, clinicopathological stage, type of operation, method of reconstruction), anthropometric characteristics (height, weight, skeletal muscle mass, body fat mass, body mass index (BMI), percent body fat, arm muscle circumference AMC, arm circumference AC) and biochemical characteristics (hemoglobin Hb, hematocrit Hct, mein corpuscular volume MCV, mean corpuscular hemoglobin MCH, total lymphocyte count TLC, serum albumin, serum transferrin). Mean ages were 60.0 yrs in males and 58.8 yrs in females. Age, clinicopathological stage, types of operation and reconstruction methods were not significantly different between males and females. Weight, skeletal muscle mass, body fat mass, BMI, percent body fat, AMC and AC significantly deteriorated by gastrectomy. There were severe weight losses in males and females after gastrectomy. Hemoglobin, Hct, MCV, MCH, TLC, albumin and transferrin significantly deteriorated by gastrectomy. After gastrectomy, subjects who were assessed as malnounrished in Hb and Hct were increased in male and those who were assessed as malnounrished in Hb were increased in females. These results suggest that a nutrition intervention, specially for energy, protein and iron, is necessary to improve the nutritional status of gastric cancer patients with gastrectomy.

• Archives of Pharmacal Research
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• 제27권4호
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• pp.449-453
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• 2004

Effect of pre-treatment with hot water extract of marine brown alga Sargassum polycystum C.Ag. (100 mg/kg body wt, orally for period of 15 days) on HCI-ethanol (150 mM of HCI-etha-not mixture containing 0.15 N HCI in $70\%$ v/v ethanol given orally) induced gastric mucosal injury in rats was examined with respect to lipid peroxides, antioxidant enzyme status, acid/pepsin and glycoproteins in the gastric mucosa. The levels of lipid peroxides of gastric mucosa and volume, acidity of the gastric juice were increased with decreased levels of antioxidant enzymes and glycoproteins were observed in HCI-ethanol induced rats. The rats pre-treated with seaweed extract prior to HCI-ethanol induction reversed the depleted levels of antioxidant enzymes and reduced the elevated levels of lipid peroxides when compared with HCI-ethanol induced rats. The levels of glycoproteins and alterations in the gastric juice were also maintained at near normal levels in rats pre-treated with seaweed extract. The rats given seaweed extract alone did not show any toxicity, which was confirmed by histopathological studies. These results suggest that the seaweed extract contains some anti-ulcer agents, which may maintain the volume/acidity of gastric juice and improve the gastric mucosa antioxidant defense system against HCI-ethanol induced gastric mucosal injury in rats.

• 대한한방내과학회지
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• 제35권2호
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• pp.208-221
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• 2014

Purpose : Banhasasim-tang (BHSST) has been applied for treating the symptom of gastric stuffiness, which is similar to dyspepsia. The object of this study was to observe the healing effect of BHSST on the indomethacin (IND)-induced gastric ulcer in rats. Methods : Three different dosages of BHSST (400, 200 and 100 mg/kg) were orally administered 30 min before IND treatment; 6 hrs after IND treatment, the changes on the gross lesion scores, fundic histopathology, myeloperoxidase (MPO) activity, lipid peroxidation and antioxidant defense system (glutathione contents, catalase (CAT) and superoxide dismutase (SOD) activities) were observed, and compared with the activity of the synthetic anti-ulcer drug, a representative proton pump inhibitor omeprazole (OME) 10 mg/kg. Results : All three different dosages of BHSST treatment in the IND-induced gastric ulcer rats, significant and dose dependent decreased gastric damages - hemorrhagic gross lesions, gastric mucosa MPO levels and histopathological gastric ulcerative lesions - were detected as compared with the IND treated control rats. BHSST also strengthened the antioxidant defense systems - decreased the level of lipid peroxidation and CAT activity but increased the level of GSH and SOD activity, and BHSST 200 mg/kg showed similar anti-ulcerative effect as compared with OME 10 mg/kg. Conclusions : The results obtained in this study suggest that BHSST has favorable effects against IND-induced gastric damages, through significant and dose-dependent decreasing gastric damages and the strengthening of the body's antioxidant defense systems with direct anti-inflammatory effects.